Healthcare Provider Details
I. General information
NPI: 1952925885
Provider Name (Legal Business Name): INERTIA PHYSICAL THERAPY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/06/2020
Last Update Date: 08/18/2022
Certification Date: 08/18/2022
Deactivation Date:
Reactivation Date:
III. Provider practice location address
406 GARSTON CT
STALLINGS NC
28104-0053
US
IV. Provider business mailing address
406 GARSTON CT
STALLINGS NC
28104-0053
US
V. Phone/Fax
- Phone: 316-518-5095
- Fax:
- Phone: 316-518-5095
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QP2000X |
| Taxonomy | Physical Therapy Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
STEPHANIE
LEWIS HART
Title or Position: OWNER, MANAGER
Credential: PT, DPT, ATC
Phone: 316-518-5095